"You who bring good tidings... lift your voice with a shout... do not be afraid... 'Here is your God!'" (Isa. 40:9)

Choices: Managing Chronic Pain to go on-line

Posted on September 13th, 2011 in Choices, Health Bible Studies, Worship, Life Issues, Health News by Jonnie Wright

ON-LINE BIBLE STUDY FOR CHRONIC PAIN IS ON ITS WAY

Please let me know if an on-line study would be of interest to you. Choices: Managing Chronic Pain will be the text used. It will only cost $12 and I will absorbe the shipping costs. If you click on the book to your right, you will find out more about the book we’ll be using. I am going to try to schedule the study at 12:00 noon so that those who work can join in as well.

Feed-back at this time would be most useful so that I might determine if there is anyone interested. If you know someone who lives with chronic pain or if you are a caretaker, this study will be encouraging support as one’s painful condition keeps changing your life-style choices.

You may email me at jonnie@jonniewright.com subject line: on-line Bible study. Or you may want to visit my other sites: www.jonniewright.com and http://jwright.vpweb.com.

We don’t grow by doing a Bible study, we grow as we go through it.

Take the Survey!

Posted on March 25th, 2011 in Health News by Jonnie Wright

Dear APF Member,Do you or someone you know suffer from chronic widespread pain and tenderness?  Have you been suffering for three or more months?  Then it’s possible that you may have fibromyalgia.

In an effort to help people who live with pain every day, we are launching a new survey to learn about the impact of the condition from your perspective and hear some of the management tips you employ to improve your quality of life.  We hope to help people who live with chronic pain and encourage them to talk to their health care provider.

Getting a diagnosis of fibromyalgia, along with education about the condition, is an essential first step in better managing the symptoms of the condition. We hope this survey will help communicate the importance of taking that step to people living in chronic pain. 

With your support, we can help encourage those living with chronic widespread pain and tenderness to work with their health care provider to get a diagnosis that’s right for them and find the best management plan.

Support our efforts – take the survey TODAY!

The survey was developed in collaboration with the National Fibromyalgia Association and supported by Pfizer Inc.

Thank you for your support,

American Pain Foundation

Heads Up on Comprehensive Newsletter

Posted on March 4th, 2011 in Fibromyalgia, Health News by Jonnie Wright

  There are so many great newsletters out there. Fibromyalgia Network is one of the best. Instead of trying to pick out one or two articles, I am letting your read their whole newsletter to see what you’re missing if you haven’t got your own subscription. I hope you will find it as interesting and informative as I do and subscribe for your own version. JW

View this in your web browser.  

Fibromyalgia Network
   February 2011 eNews Alert
In this eNews:


Questions?

Call: 1 (800) 853-2929
E-mail: kthorson@fmnetnews.com
Visit: www.fmnetnews.com


Reader-Friendly Version

This eNews is available for viewing and printing in a larger size.

Dear Jonnie Wright,

Commitment to a job, child or grandchild can fill you with a sense of purpose, but can it also wear you thin? A new study in this month’s Latest News looks at the impact employment and caregiver roles have on the overall health of people with fibromyalgia (FM). In general, FM patients appear to respond differently to regular commitments than people from the community who are matched for age but don’t have FM.

Troubled by joint stiffness or painful bladder? Research confirms the high prevalence of these two symptoms in FM and offers an explanation for what makes them tick. Exercise intolerance is another bothersome symptom and a recent study sheds light on why people with FM have trouble initiating an exercise program. If your treatment plan leaves you guessing about FM and wishing you had more time with your doctor, read about a new program being tested in Spain.

Hope 2011 is shaping up to be a good year!

Kristin Thorson
Fibromyalgia Network Editor

Fibro Patients Benefit from Role Commitments
Staying employed with fibromyalgia can obviously provide you with social support and economic rewards. However, Laura Zettel-Watson, Ph.D., states, “Middle-aged and older adults often occupy several roles simultaneously; for example, they may be employed as well as giving care to children, grandchildren, or parents.” So the question that needs answering is: How does employment and caregiving impact the overall health of people with fibromyalgia?

Read the complete article in the Latest News section of our website.

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Joint Stiffness
Stiffness is a common symptom of fibromyalgia (FM). Typically it is worse early in the morning and then it may ease up some by midday. Yet, the joints are not swollen in fibro as they might be in patients with arthritis. However, a recent study by a team in Belgium documented the presence and degree of severity of this symptom in three different age groups of FM patients.*

As we age, we expect to get more arthritis and stiffness in the joints. This means that measurements of stiffness will be influenced by a person’s age, so the researchers looked at this symptom for three different age groups. The average age of the three groups of FM subjects were 26, 45, and 70 years. For comparison, three groups of healthy controls of similar age were also recruited for this study. All subjects had the musculoskeletal stiffness of their ankle measured by a device that moves the foot passively to both extend and flex the ankle.

All three of the FM age groups rated their ankle stiffness close to 5 on a scale of 0 to 10 (where 0 is no stiffness and 10 is worse possible stiffness). The degree of ankle stiffness measured by the device in the younger and middle-aged FM patients was more than twice that of the age-matched controls.

“The self-perceived stiffness increase in the ankle reported by younger and middle-aged FM subjects is due to changes in the elastic structures around the ankle,” state the authors of the study. “However, stiffness differences were not observed in the older FM women.” Does this mean that as patients age, they outgrow the symptom of stiffness? No. As people age, the symptom of stiffness increases. In this study, the measured stiffness in the older group of healthy controls increased significantly, leaving little difference between the controls and the older FM patients.

This study shows that the degree of joint stiffness in young to middle-aged FM patients is more than twice that of healthy controls. Joint stiffness is likely present to a greater extent in the older FM group as well, but it may not differ substantially from the degree of stiffness that healthy people get with normal aging.

* Dierick F, et al. Nature of passive musculoarticular stiffness increase of ankle in female subjects with fibromyalgia syndrome. Eur J Appl Physiol [Epub ahead of print] Feb. 6, 2011.

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Bladder Pain and Fibro
What does interstitial cystitis (IC) have to do with fibromyalgia (FM)? A study looking at 312 cases of women with IC sought to answer this question.* In addition, the study examined the association of IC with chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), and sicca syndrome (dry eye syndrome)—conditions that overlap substantially with FM.

The symptoms of IC include bladder pain with urgency and frequency (day and night). Pain worsens with bladder filling and improves with voiding. The 312 people with IC evaluated in this study had experienced bladder symptoms for less than one year. This enabled the authors to examine the medical records for each IC patient during the preceding year to search for evidence of other non-bladder syndromes that might pre-date the onset of IC.

When the IC patient had one or two non-bladder symptoms preceding the onset of IC, allergy was most often one of the conditions that pre-dated the IC. Allergy just happened to be very common and appears coincidently with IC. However, when five or more non-bladder symptoms preceded the onset of IC, a different picture unfolded. FM, CFS, IBS, and sicca syndrome were the most common pre-existing conditions. Not only do these conditions overlap with one another, pain is a prominent feature for all.

The authors present two likely hypotheses to explain their findings. One is that the onset of FM, CFS, IBS, or sicca syndrome might possibly contribute in some way to the process that triggers the development of IC. The other possibility is that each of these non-bladder syndromes and IC might be caused by a shared abnormality. Well-designed studies to follow the development of these syndromes in patients will be needed to distinguish between these two hypotheses.

* Warren JW, et al. Numbers and Types of Nonbladder Syndromes as Risk Factors for Interstitial Cystitis/Painful Bladder Syndrome. Urology 77:313-320, 2011.

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Moving Past the Exercise Hurdle
Low-intensity exercise is often recommended to people with FM to help maintain physical function. Yet finding the right level of activity is often a challenge because overdoing it can easily lead to an exacerbation of FM pain. This paradox may occur due to an alteration in the way the body’s sympathetic nervous system responds to an exercise challenge in people with FM.

The physiologic responses to a sustained contraction of the thigh muscles in FM patients were compared to the results obtained for healthy control subjects. The study led by Eva Kosek, M.D., Ph.D., of Sweden, placed particular focus on examining the role of the body’s fight-or-flight sympathetic nervous system, which is involved in regulating muscular blood flow and influencing the modulation of pain.*

During a sustained contraction lasting up to 20 minutes, the sympathetic nervous system should become activated and trigger the adrenal glands to secrete adrenaline. However, the patients with FM had reduced adrenaline levels before the start of the contracting exercise as well as during it. The sympathetic-adrenal system was hypo-active in the FM patient group, but this was not the only problem.

During exercise, the hypothalamic-pituitary-adrenal (HPA) system should also become activated to release more ACTH, a stress hormone from the pituitary. In the healthy controls, the ACTH secretion increased during the sustained contraction (as it is supposed to), but this hormone remained unchanged in the FM patients. So not only is the sympathetic nervous system under-active in FM, but the the HPA system doesn’t react to the stress of exercise the way it does in healthy control subjects. According to Kosek, these two findings could contribute to exercise intolerance in FM patients.

So what about the recommendations of low-intensity exercise for people with FM? Kosek comments that regular exercise should help restore the function of the sympathetic-adrenal system and the HPA response system. In turn this should lead to improved muscle blood flow and reduced pain. At the start of an exercise program, your body may seem exercise intolerant. However, with continued low-intensity practice, you will get over the hurdle and it should eventually become easier.

* Kadetoff D, Kosek E. Evidence of reduced sympatho-adrenal and hypothalamic-pituitary activity during static muscular work in patients with fibromyalgia. J Rehabil Med 42:765-772, 2010.

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Adding More to Standard Care Shows Benefit
A little knowledge can go a long way when it comes to alleviating symptoms related to fibromyalgia.

Researchers in Barcelona, Spain wanted to know if newly diagnosed fibromyalgia (FM) patients who participated in a program that offered management strategies beyond the “standard course of treatment” would find more symptom relief.* FM patients from the region were randomly assigned to one of two groups for treatment.

General practitioners provided one-half of the group (108 patients) with the usual care that included medication to help with treating individual symptoms. This control group was also counseled about how to perform aerobic exercise with modifications made to accommodate the physical limitations of FM.

The study group of 108 patients was also provided with the usual care. In addition, the patients were enrolled in an educational program that consisted of nine, two-hour classes. They were divided into small groups of 18 for their weekly sessions. Five of the classes focused on typical symptoms, potential causes of their illness, related medical conditions they may experience, current medications available, the long-term effects of pain on their lifestyle, the benefits of regular exercise, and typical barriers they would face. Another four classes offered patients lessons in physical and mental relaxation, pain relief through distraction techniques, and stress reduction. The classes were given by four general practitioners, a rheumatologist, and a psychologist. Patients in the study group were encouraged to ask questions and discuss the issues with the speakers. They also were allowed to talk with other patients in the group, share experiences and emotions.

Patients in both groups were allowed to drop out of their program at any time over the course of the treatment plan. After nine weeks, seven patients in the study group had dropped out, while twice as many patients who were receiving standard treatment quit. Overall, more than half (53%) of the study group participants felt they benefitted from the program with at least 20 percent symptom relief. Only 17 percent of the control group felt they benefitted from their treatment. Specifically, the study patients reported improvements in physical function, pain, fatigue, stiffness, anxiety, depression, and the number of days they felt well.

The researchers attribute some success of the study group to the patients themselves who credit the doctors for investing their time and effort to treat them, but the “tendency to please is not likely to be the main cause of the improvement,” the published study says. “We suspect that patients’ motivation and expectations may have greater importance. Our findings indicate that … education and relaxation made by an interdisciplinary team is an effective treatment for FM, at least in the short term.”

When the study ended, the authors could not predict if the improvements would be permanent. But there is no harm in continuing your own study by practicing relaxation techniques and seeking out information for a better understanding of FM and improved ways to cope with this illness.

* Luciano J et al. Effectiveness of Psychoeducational Treatment Program Implemented in General Practice for Fibromyalgia Patients: A Randomized Control Trial. Clin J Pain [Epub ahead of print] Feb 11, 2011.

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You Know You Have Fibro When …
As submitted by our Fibromyalgia Network Facebook friends for your shared amusement:

  • the microwave beeps and I look in the freezer.
  • I sprayed my hair with spray deodorant instead of hair spray. Both are blue spray bottles … now I wonder if I have done that before and just didn’t notice.
  • I couldn’t find the bagel I was preparing for lunch when I realized I had already split it and placed in toaster.
  • I notice that most things I lose end up in the freezer. Now, that’s the first place I look when I’m missing something.
  • I pour a cup of coffee, then I can’t find it. I pour another cup and lose that too. I pour more coffee—can’t find it. I find four cups of coffee all together. They are stone cold, the pot is empty, and I have a “caffeine headache” from a lack of coffee.
  • I poured diet soda on my cereal and didn’t register anything was wrong until I took a spoonful.
  • I walk around at work with a pen and paper just in case someone asks me to do something. If I don’t write it down, I might forget it by the time I get back to my desk.
  • I have tried to use my work swipe card to get in the front door of my house.
  • I was talking on the speaker phone to my sister. I told her I had to let the dog in and would be right back. We started talking again and she said she could hardly hear me. That’s because I was talking into the TV remote control.
  • I am driving with my husband. We are deep in conversation and I have to ask … “Where were we going again?”

Join Us on Facebook

FacebookThe Fibromyalgia Network invites you to share your ideas on our Facebook page. With more than 8,600 Facebook friends, the site offers a variety of topics related to your symptoms and lifestyle-management issues pertaining to fibromyalgia. The Fibromyalgia Network staff loves reading all of your comments, stories, and humor. Please keep telling others that we are here on Facebook by sharing the link below.

Share with us on Facebook today at
www.facebook.com/FibroNetwork

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from the Fibromyalgia Network.

Be a voice for Fibromyalgia

Posted on November 6th, 2010 in Fibromyalgia, Health News by Jonnie Wright

Medicare Model Guidelines 2012-2014: Open for Public Comment

 (November 2, 2010)

Call to action: Request that fibromyalgia be included as a therapeutic category

ACT NOW AND LET YOUR VOICE BE HEARD!

The U.S. Pharmacopeia (USP) has created the Model Guidelines Expert Panel, which is responsible for reviewing and updating the USP Medicare Model Guidelines v5.0. This is the document used by prescription drug plans to determine medication coverage. People affected by pain have a chance to speak out and request that fibromyalgia be included as a therapeutic category.  Currently, there is no such classification option.

The public has been invited into the decision-making process and can submit public comments from November 1 to November 30, 2010. 

  • Any interested party may submit written comments to the USP Model Guidelines Expert Panel for their consideration.
  • To submit a written comment, please send an e-mail to ModelGuidelines@usp.org before November 30, 2010.
  • Results of the expert panel deliberations, as well as submitted comments and source materials, will be available to the public through the USP website with the posting of the final USP Medicare Model Guidelines v5.0 to Centers for Medicaid and Medicare Services (CMS).
  • Public open microphone web meetings will be held on November 4, 8, 11, and 16, 2010.

The Model Guidelines Expert Panel will deliberate through early 2011. They will:

  1. Review current scientific evidence related to newly FDA-approved medications and their clinical indications.
  2. Determine the placement of medications within the USP Medicare Model Guidelines therapeutic categories and pharmacologic classes.

For more information, see: http://www.usp.org/hqi/mmg/.

If fibromyalgia fails to be included as a therapeutic category, the FDA-indicated medications approved for managing fibromyalgia will continue to be left out of the Medicare Model Guidelines as recognized pain treatments. This reinforces the misconception that fibromyalgia is not a legitimate medical condition and this oversight may cause the continual denial of insurance coverage for appropriate pain treatment options of this painful condition.  

Let the USP know that:

  • Fibromyalgia is a legitimate, painful, chronic condition and should be added as a therapeutic category.
  • The expert panel must review the scientific evidence related to the newly FDA-approved medications for fibromyalgia so that they are appropriately considered as viable treatment options in the guidelines.
  • Access to appropriate pain treatment is critical for a productive quality of life while living with pain. Any effort to curb access by insurance companies that interferes with quality clinical practice is not acceptable.
  • Share your pain story related to how your life has been affected by the denial of pain treatment recommended by your medical provider and denied by your insurance company.

Thank you for helping protect the rights of people with pain!

American Pain Foundation

To Connect and Support our Efforts: 

Stormy Weather Could be Disrupting Your Sleep

Posted on October 30th, 2010 in Fibromyalgia by Jonnie Wright
This article confirms what I have long believed. The change in barametric pressure certainly affects my moods, behavior, and pain levels. If I know anyone with FM, I find that they are experiencing pain at the same time I am as the weather shifts… Here’s more on that subject…
Research shows that drops in atmospheric pressure (same as barometric pressure) cause a worsening in the symptoms of fibromyalgia (FM). Whenever there are clear blue skies, the atmospheric pressure is relatively high. However, when a storm front moves in, the pressure drops and many people with FM say that they can actually sense this change in weather. Basically, their fibro symptoms become worse, but why?

A recent study by Nathaniel Watson, M.D., and colleagues at the University of Washington in Seattle, could help explain why you feel lousy when the atmospheric pressure takes a dive.* He looked at the impact of atmospheric pressure on the overnight sleep study results of 537 people who were being evaluated for obstructive sleep apnea (OSA). OSA is a disorder in which the pharyngeal airways collapse, causing the blood oxygen to drop, and eventually leading to an interruption of sleep as the person gasps for air (causing the airways to re-open).

Treatment of OSA involves the use of positive airway pressure administered into the nasal passages to prevent the soft tissues at the back of this cavity (e.g., the pharyngeal tissues) from collapsing. OSA is estimated to occur in about 20 percent of FM patients, but a more common breathing-related sleep disorder is upper airway resistance syndrome (UARS). UARS may occur in 90 percent of FM patients and is a source of sleep disruption. The airways do not completely close off in UARS, but the treatment is the same although the air pressure requirements are much less.

So, what happens to people with OSA when the atmospheric pressure drops? Watson found that the severity of their apnea increased, which means that their sleep became more disrupted. What about UARS, which is more likely to be present in FM patients? Watson did not test patients with this condition, but he speculates that this sleep disorder would also worsen with a drop in atmospheric pressure.

Now you may be wondering: What is it about a reduction in atmospheric pressure that could alter the severity of OSA and possible UARS?

“Perhaps there is a critical threshold during which air pressure assists, albeit minimally, in holding pharyngeal airways open and therefore preventing an obstructive event,” writes Watson and colleagues. If you have OSA or UARS (the latter of which is seldom treated), a drop in the air pressure would make these two sleep disorders worse. Or, even if you are being treated for either of these breathing disorders, chances are that the pressure setting on your air delivery machine is fixed and may become inadequate when the atmospheric pressure drops.

The bottom line: a lower atmospheric pressure means you have less airway “force” to assist with your breathing during the night. The result is a potential worsening of sleep, which in turn can snowball into more FM pain. Although you have no control over the weather, you can at least be proactive with keeping your airways open (e.g., saline sprays, anti-allergy medications, etc.), and structurally prop your chest open with pillows for optimal breathing. At least you can fall asleep knowing that you have done your part to improve your nighttime breathing.

* Doherty MJ, et al. J Clin Sleep Med 6:152-156, 2010.

Dealing with Frustrations and Fears

Posted on October 30th, 2010 in Fibromyalgia by Jonnie Wright
I found this article extremely enlightening. Hope you agree…
Been on edge lately? You are not alone. Many patients have experienced frustrations that have led to aggravating outbursts. The October issue of the Fibromyalgia Network Journal offers marvelous tips from the experts and patients to manage anger and the often overwhelming emotions caused by your illness.

…here are additional tips and suggestions from Cinda, a Network Member on Facebook.

“If I feel the out of control thing coming on, I hide out in my ‘cave’ and demand peace and quiet. The key is not feeling guilty about it - oh, that is the hardest part. Guilt just makes it all worse. I try not to piss anyone off I care about. And talking about it with others who get it is a huge help.”

“I don’t take my fibro personally. That sounds weird, but it’s not something I did or that someone did to me. It just is. I can choose to cope and accept or succumb to a life of negativity and bitterness.”

Use anger constructively. Be proactive and research ways to fight back. Educate yourself about FM, then find a good doctor. Keep searching for the right combination of meds, try alternative treatments, get some counseling.

Don’t take things personally. When your insurance doesn’t pay, Social Security Disability is denied, or your boss doesn’t believe you, don’t take it personally. If you treat it like it is just business, it can help you cope better.

Fight for your rights. Don’t let FM consume you without a fight. Take steps to obtain disability, a real caring doctor, legal representation, or whatever it is you feel you are due. The fight alone will give you some power over the disease, a reason to get up in the morning, and distract you from other problems including symptoms.

Breathe. Practice meditation, yoga, tai chi or anything that causes you to purposefully breathe.

Walk. Walk away from a situation that is making you upset. This gives you time to compose yourself. When you walk back in, your mind will be calmer and clearer.

Distractions. Listen to music, put on a funny TV program, put together a puzzle, grab a cloth and clean – whatever helps to put your mind somewhere else and ease the immediate tension.

Stop feeling guilty. You did not ask for this illness so why feel guilty?

Stick to what works. Keep on schedule with your meds, supplements, sleep, CPAP, activity, or whatever works for you. Do it regularly to give it a chance to help you.

Take responsibility. Other people do not make you angry, it is our perception of a situation that causes us to react. Remove the blame and try to identify the source of the anger.

Socialize. Join a support group or visit Fibromyalgia Network on Facebook to talk, vent, and offer your coping advice about this issue with others who understand where you are coming from. Visit the Discussion Board on “Anger? Frustration? Depression?” to offer your input.

New Book Soon To Be Out

Posted on October 16th, 2010 in Health News by Jonnie Wright

THE BETTER BLADDER BOOK

A Holistic Approach

To Healing Interstitial Cystitis & Chronic Pelvic Pain

Wendy L. Cohan, RN

Hunter House Publishers / PO Box 2914 / Alameda CA 94501 / (510) 865-5282 / Fax (510) 865-4295 / www.hunterhouse.com

B O O K S F O R H E A L T H , F A M I L Y A N D C O M M U N I T Y

This book reveals:

1. The signs and symptoms of interstitial cystitis

2. The natural way to a healthy bladder

3. What to do to alleviate pelvic pain if changes to your

diet, lifestyle and the use of medications don’t work 

Leave No Stone Unturned in Your Quest for Bladder Wellness

(Alameda, CA—October 2010) As many as eight million Americans may suffer from interstitial

cystitis, which causes urinary urgency and frequency, along with moderate to severe pain. But the

stigma surrounding this disorder means many people suffer in silence. Wendy Cohan, RN, has

transformed her personal experiences as an IC patient into an effective holistic treatment plan. She

wrote The Better Bladder Book to give people who suffer from health problems—including IC,

overactive bladder, pelvic floor dysfunction, and chronic prostatitis—a new approach in their quest

for improved health, free of bladder symptoms and pelvic pain.

In layman’s terms, Cohan details bladder anatomy and explains how the urinary system works. She

then cites the most common bladder disorders and describes their symptoms, diagnosis and

treatments. Cohan doesn’t abandon the reader at diagnosis, or even treatment, but instead guides

readers through a comprehensive list of tools and tips for ongoing self-management, and helps

readers carefully track their progress and recovery.

The Better Bladder Book picks up where medical treatment leaves off, as Cohan presents current

research studies that explain why bladder and pelvic health are improved by daily exercise, important

dietary changes (including a gluten-free, anti-inflammatory diet), identification and avoidance of food

allergies, and, very importantly, stress reduction. Because experiencing chronic stress can lead to

uncomfortable pelvic floor tension and other symptoms, The Better Bladder Book emphasizes effective

stress reduction techniques such as progressive muscle relaxation, deep breathing, and other calming

activities. The role of hormones in bladder and pelvic health is explored, and Cohan informs the

reader of the connection between IC and adrenal fatigue, which can be triggered by menopausal

changes, and exacerbated by stress.

If medications, dietary changes, hormone balancing, and a lower-stress lifestyle aren’t enough to bring

about bladder wellness, Cohan writes that there may be additional problems that were not identified

during the initial diagnosis. She expertly discusses many of these conditions, including hidden or

“occult” bacterial infections, yeast overgrowth, and Lyme disease, while encouraging the reader to

continually self– assess, learn the body’s unique alarms and symptoms, and to regularly consult with

doctors.

Cohan’s goal is to “leave no stone unturned” in the quest for bladder health. With a first-of-its kind,

comprehensive and holistic approach to healing, readers will finally have all the information they

need to achieve success in their journey toward better bladder health and a life free of chronic pelvic

pain.

###

ABOUT THE AUTHOR: Wendy L. Cohan, RN, is an author, educator, a registered nurse, and a

former sufferer of Interstitial Cystitis (IC). Emphasizing a patient-centered, holistic approach, she

helps clients gain control over their bladder disorders and live free from pelvic pain. A public speaker,

she maintains two websites (www.wellbladder.com and www.glutenfreechoice.com). Her first book

was Gluten-Free Portland-A Resource Guide. The Better Bladder Book updates and end notes can be foundat www.thebetterbladderbookinfo.com. Cohan lives in Portland, Oregon.

Posted on October 14th, 2010 in Health News by Jonnie Wright

RESOURCE GUIDE FOR PEOPLE WITH PAIN

We are pleased to bring you the In the Face of Pain® “Resource Guide for People with Pain.” Our goal is to provide you with a resource to help you on your day-to-day journey as you face challenges so often encountered by those who suffer from pain. This resource will provide you with a variety of information, ideas, and tools that we encourage you to use and share with others.

The Resource Guide includes information about:

  • Your Pain Assessment Tools
  • Your Treatment Plan
  • A Healthier You
  • Focus on Caregiving
  • Special Consideration for Seniors
  • Financial Issues and Resources
  • Purdue Pharma L.P. Resources

To download your free copy now, click here.

To order additional free copies of the printed brochure, click here.

Resource Guide for People with Pain

Posted on October 5th, 2010 in Health News by Jonnie Wright

Posted on October 4th, 2010 in Fibromyalgia, Health News by Jonnie Wright
Drug Treatment Trends
There are three FDA-approved medications for treating the pain of fibromyalgia (FM), and you might wonder: how has this impacted the prescribed drug treatments for FM patients in the general community? Prescription information from February 2009 to January 2010 was analyzed for patients with FM using a large database obtained from SDI Health.* This comprised the Trend Watch data.

The analysis was based on 3,200 office-based physicians who enter into the database a specific insurance code representing their reason for why a given drug is prescribed. Medicine prescribed specifically for FM had a diagnosis code of 729140, which enabled the investigators to assess which medications were most often prescribed for FM patients.

According to the SDI Health data, “82 percent of patients are prescribed only one agent, 12 percent are prescribed two products (i.e., drugs), and 6 percent are prescribed three or more products,” state the lead author, Peter Dussias, a data analytics expert. Lyrica (pregabalin) was the most commonly prescribed single-therapy medication at 21 percent, followed by Cymbalta (duloxetine) at 20 percent, and Savella (milnacipran) at 10 percent.

Looking at the different categories of drugs prescribed, the most common were antidepressants at 46 percent (primarily the FDA-approved Cymbalta and Savella, with some tricyclic agents). Antiepileptics were the second most common category at 35 percent, mostly consisting of Lyrica and a few other similar type of medications. Other classes included pain therapies (25 percent), muscle relaxants (8 percent), and sleep agents (2 percent).

FM researcher Roland Staud, M.D., of the University of Florida in Gainesville, was invited to comment on the data (he had nothing to do how it was generated). He indicates that about half of the patients treated with any one of the FDA-approved drugs will receive a 30 percent reduction in pain. Staud adds that this suggests “that many patients with FM will require additional therapies. Thus it is interesting that, according to the Trent Watch data in this article, most FM patients (82%) treated by a variety of medical specialists had only one drug prescribed for treatment of their symptoms.”

Staud further comments that based on the limited number of medications prescribed for FM, one may surmise one of two things:

  • FM patients in general clinical practice have lower pain levels or that they find non-drug strategies to work well enough to contribute to satisfactory treatment.
  • “On the other hand, one could also conclude that many FM patients have been left undertreated.”
    The study did not include information about how effective patients felt their treatments were, so it is impossible to know which of the above options is most likely the case.

Offering additional input on interpreting this data, Richard Podell, M.D., M.P.H., a clinical professor in the department of family medicine at UMDNJ-Robert Wood Johnson Medical School, says he does not doubt that most FM patients are given only one drug. Just as Staud pointed out, Podell says, “This could reflect mild disease that’s being treated appropriately.” However, he adds, “Most physicians feel overwhelmed by the polysymptomatic patient (such as those with FM) and have been trained to dislike polypharmacy. Also, in a field where they feel not too confident, most physicians will not want to go beyond the FDA-approved choices.”

One other point made by Podell that could explain the data is that the methods used in the study look for medications specifically prescribed for FM. “The answer might be that they are only on one fibro drug,” says Podell, and this could explain the high incidence of the FDA-approved meds for FM. Then to treat the patient’s sleep, they may be given a drug that is coded for insomnia. To treat their tight muscles in the neck and shoulders, they might be given a muscle relaxant using a drug coded for a regional pain disorder.

Clearly, how the drug gets coded for each condition that they are being prescribed for will greatly impact how the data is interpreted. One point that stands out is that the three FDA-approved drugs are very commonly prescribed for patients with FM. Find out in the October 2010 Journal which one, if any, might be best suited to fit your needs.

* Dussias P, et al. Psychiatry 7:15-18, 2010.

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